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| Agendas and the Chaplaincy When I first started doing the work of a hospital Chaplain and still had much to learn, I visited a patient on the oncology floor in the hospital where I ministered. He looked pale and obviously uncomfortable. After introducing myself I said something like, “I came by to see if I could encourage you.” He looked at me rather sternly and said, “I don't need to be encouraged. I need sleep.” Fortunately I learned much from that rookie mistake. I learned never to assume that I knew what was best for a patient. To do so is to have a faulty agenda, and as you will read, that is a mistake. The dictionary defines the word agenda as, “Things to be done.” As it applies to the chaplaincy it means to initiate a visit with an objective or a plan of action based on the needs or desires of the Chaplain rather than the needs or desires of the patient. It means that the Chaplain, not the patient, determines the direction the visit takes. Our agenda could be to offer or provide some very good things. It had been my agenda to encourage the patient mentioned previously, to bring some spiritual comfort and support a man sick from cancer. Certainly there couldn't be anything wrong with that. After all, I was motivated by a heart-felt desire to help someone in need. Actually, there is plenty wrong with that type of approach. First, I assumed he needed or wanted my help. Then I assumed I knew what kind of help he needed without first getting to know him or even spending any time with him. I saw a sick man and jumped to conclusions. Because I entered the room with an agenda I assumed to know the needs of someone without bothering to listen and hear what the real needs were. As a result, the patient felt discounted. There are many different agendas that can influence our ministry to patients and residents. For the sake of clarity I will categorize these agendas under Personal Agendas and Professional Agendas. Keep in mind that the agendas I will be discussing are faulty agendas, agendas that hinder effective ministry in the healthcare setting. Personal AgendasMeeting One's Own Needs Studies have shown that some people who enter occupations that are primarily geared toward meeting the needs of others, such as counselors and ministers, were reared in seriously dysfunctional families. They have a basic need to help others in order to gain acceptance and to feel better about themselves. Outwardly they appear very loving and self-sacrificing. In reality, they are seeking to meet their own needs. When this is the case, there is a tendency to put meeting the needs of a person before the person himself. A patient, for example, is viewed as a need to be met instead of a person who has value and is worth getting to know and understand. This first type of personal agenda can be very harmful, especially for the Chaplain. Early burn out is a very strong possibility. And no one will understand because people will have viewed the Chaplain as being wholly characterized by love and compassion for others. This agenda may also hurt or upset the patient who is left feeling discounted and insignificant because the Chaplain never bothered to hear him or her and has now gone off to find a patient with more serious needs. It is also important to point out that the Holy Spirit can and does free ministers from the chains of coming from a dysfunctional family. I still maintain, however, that it is vital for ministers to administer frequent awareness checks to prevent a faulty agenda from becoming a dominating factor in ministry. Having Prejudices A second type of personal agenda describes those attitudes and actions that stem from feelings deep inside us, feelings to which we may be blind. This agenda can influence our ministry as Chaplains when we encounter people who are different from us—people of different race, sexual orientation, religion, economic or social class, age, etc. In other words, the prejudices that inflict our entire world can also show their ugly heads in the hidden agenda of Chaplains. Although outwardly we may appear to be ministering out of love, there is an inner attitude of disapproval, judging, or looking down our nose at someone. You may be saying, “No, this doesn't apply to me. I don't have a problem with prejudice. I love everyone.” I hope this isn't our attitude. Do you have a problem with smokers who can't quit even though they are killing themselves? I do. How about obese people or blatant sinners? Are you prejudice-free when dealing with homosexual AIDS patients? May we all seek to be open-minded about ourselves and be willing to regularly exercise the discipline of self-evaluation. If we aren't aware of our prejudices and admit to them, a hidden agenda will be at work when we visit certain types of patients. That's not good, to say the least. Escaping Difficult Situations There is a third type of personal agenda that I call an escape agenda. It influences our ministry when we encounter a patient or situation that makes us feel very uncomfortable and uneasy. For example, I have a problem with whiners, patients who complain and cry about relatively minor problems. There is a part of my personality, a subject not related to this paper, that cannot deal with people who whine. I find myself not listening to the patient but thinking of a polite way to make my escape. There are certain situations that could cause a Chaplain to enter an escape mode, perhaps a smelly room, a jaundiced patient, or a crisis involving a small child. It is likely that most Chaplains have a certain type of patient or situation that triggers the escape agenda. When this is the case, it is necessary to be fully aware of the source of those inner feelings and begin to work on them. Otherwise we will always become uncomfortable and uneasy and will have to leave ministry to that patient to someone else. Professional AgendasConcerning the role of healthcare Chaplains, Lawrence Holst writes:
Holst goes on in his book to describe the many functions of the Chaplain, the “ways and means whereby role is implemented.”² There are numerous factors that determine the functions that a Chaplain may emphasize in his or her ministry. Some of these are the expectations of the healthcare organization in which a Chaplain ministers, the Chaplain's training and denominational background, personal skills and personality, and the Chaplain's own faith system. So what we find is that each Chaplain ministers in a unique way. A problem arises, however, when a Chaplain emphasizes a function to such an extent that it overshadows the overall role of a Chaplain. The role must always hold sway over a function. When it doesn't, when the function is over-emphasized, the Chaplain's ministry is pushing an agenda. I call these professional agendas and I will now consider several of these. Prayer & Scripture Reading Most Chaplains recognize that prayer is an important and necessary function. And many feel the same about the reading of Scripture. I know of a Chaplain, however, who believes that praying is his job and he pushes it on people who do not want it. He judges his own effectiveness by whether or not he has prayer with a patient. Knowing and understanding the patient is not his primary concern. Consequently, praying has become a professional agenda. It gets in the way of a personal, understanding, and compassionate ministry. Again, prayer and the reading of Scripture are important functions of the Chaplain, but I have listed them as the first type of professional agenda because their use can be inappropriate when they are pushed upon people. Evangelism Then there are the Chaplains who equate the chaplaincy with evangelism. It is their agenda to make sure a patient has accepted Christ as his or her personal Savior, especially if the patient is near death. A person's salvation is also a concern of mine and I have had the marvelous privilege of leading people to the Lord on their deathbed. But for some Chaplains their agenda is the salvation of lost souls. If they are asked about their ministry as Chaplains, they relate how many people they led to the Lord that year. In my opinion, and I know there are those who disagree with me, a Chaplain who has an agenda of leading people to the Lord is really an evangelist who happens to work in a hospital. He is not really doing the work of a Chaplain. Analyzing Patients A third type of professional agenda can be a problem especially for those Chaplains who have had CPE training. CPE training can be of great value for a Chaplain, providing skills necessary for self-examination and awareness, equipping the Chaplain to be proficient in being aware of what is going on with the patient, and giving training in asking insightful and probing questions of the patient. Problems arise, however, when the Chaplain begins looking at patients as psychological case studies, or even worse, subjects for a verbatim. I am afraid some Chaplains aspire to be what I call junior psychologists who get their kicks out of analyzing patients in order to discover root problems and needs. They have gotten their eyes off the role of the Chaplain and have become enamored by an inappropriate agenda. Institutional Visits The final professional agenda relates to the expectations placed on Chaplains by the institution in which they minister. Of course many of these expectations are necessary and should not be a problem for the Chaplain. For example, it is expected that Chaplains visit patients who are seriously ill, are scheduled for surgery, or have other special needs. These expectations are certainly acceptable. Sometimes, however, time constraints become an issue and the Chaplain finds himself trying to squeeze a number of visits into a short amount of time. Quality visits become what I call institutional visits. I face this problem when the surgery schedule arrives late to my office. There is always the temptation to conduct short, institutional visits to pre-surgery patients so that I can leave at quitting time. Some of you may minister in healthcare organizations that require the Pastoral Care Department to participate in one of the models of hospital quality assessment and improvement, such as the Total Quality Management model or the Continuous Quality Improvement model. This may require you to assess or chart each visit. For the most part this could be a benefit to your ministry, giving you credibility in the hospital and giving you a means to evaluate your ministry. But because of the time involvement, the process could also affect the amount of time you have available to spend with patients or limit the number of visits. It that case, the agenda could be to leave enough time to do paperwork. The Example of ChristWhat does it look like to minister as a Chaplain without a personal or professional agenda? Where does one find a perfect example? There is, or course, no perfect human example, except for that example found in the ministry of the perfect minister of pastoral care, Jesus Christ. Being the divine Son of God, Jesus' ministry was always and totally characterized by the manifestation of the love and presence of God. He never operated under a faulty agenda. We have no examples of Jesus ministering as a Chaplain in a hospital, but we have many examples of His ministry to needy and hurting people. From the Gospel of John, I will look at Jesus' encounter with three individuals, three entirely different individuals who had a desperate need to experience personally the love and presence of God. The first is a wayward woman, the second, a blind beggar, and the third, a doubting disciple. Hopefully these illustrations will help point the way to a ministry that is free from personal and professional agendas. The Wayward Woman The story of the wayward woman is recorded in John 4. When I study Jesus' approach with this Samaritan woman, I am impressed with the intimacy of the encounter, with the fact that Jesus was so personal with her. He did not allow the prevailing prejudices to hinder his ministry. She was a woman and a Samaritan, Jesus, a man and a Jew. But Jesus approached her as a fellow human being who had physical needs just as He did (“Will you give me a drink?”). Jesus' encounter with this woman continued on a personal level with His penetrating statements based on a personal knowledge of her life. He knew her. This knowledge didn't cause Him to judge and condemn her. He didn't press her into repenting of her sin or to acknowledge her need of a Savior. His personal knowledge of her led Jesus to gently and compassionately seek to create in this wayward woman a desire for the gift of eternal life. Jesus communicated to this woman, by establishing a personal relationship, that He cared about her. She, of course, responded, and her needs were met. Notice the three steps Jesus took in dealing with this woman. He started with her physical needs, moved on to her relational needs, and then dealt with her spiritual needs. And in the whole process He was personal and intimate with her. He was not a professional minister who kept His distance. He was understanding, compassionate, and interested in her as a person. That is an important key to being an effective Chaplain, showing interest in a person by listening and being attentive. Jesus, of course, has an infinite advantage over us. He knew all about the wayward woman because He is omniscient. He is God. We have to work at getting to know someone on a personal level, but it is a necessary work. In fact, I don't believe we have the right to deal with a patient on a spiritual level, especially since the patient has little control over who comes into her room, until we have demonstrated a real concern and interest in the patient based on a personal relationship. After we have gained the trust of a person and after she feels safe in telling us that she has had five spouses and a lover, then we know enough about the person to begin to create a desire for the gift of eternal life through Jesus Christ. A personal or professional agenda will not hinder our ministry if we follow the process of establishing a personal relationship. The Blind Beggar In chapter 9 of the Gospel of John we read of Jesus' encounter with a blind beggar. As Jesus and His disciples were walking along the road they saw a very common sight, a blind beggar. The disciples reacted in a very common way: they were callused to the beggars needs. They were only moved to bring up a theological problem. They said to Jesus, “Rabbi, who sinned, this man or his parents, that he was born blind?” (John 9:2). Unfortunately, the disciples did not see this man's pain and sorrow. But Jesus did, and He dealt with it. Notice that Jesus did not bypass the physical needs of the man to get to the spiritual needs. He did not ignore the physical sight to get to the spiritual sight. He healed the man and sent him away. It wasn't until later, when Jesus again came upon the now seeing beggar, that Jesus dealt with the man's spiritual blindness. Of course, Chaplains cannot heal the patients they visit in the hospital, but that doesn't mean they can ignore the physical needs just because they feel the spiritual needs are more important. I know there is little a Chaplain can do about a patient's physical needs, but neither can these needs be ignored in the attempt to get to issues the Chaplain thinks are important. May I suggest that one effective way to create in patients a desire to discuss spiritual needs is to demonstrate a sincere interest and concern for their physical needs. The Doubting Disciple We read of the doubting disciple in John 20. The phrase “Doubting Thomas” has become a figure of speech in our language, referring to someone who doubts but shouldn't. It is a derogatory term. We tend to judge people who are characterized by doubting. Did Jesus judge Thomas? Not in the least. When Jesus appeared to Thomas after His resurrection, and knowing of his doubts, Jesus simply said, “Put your finger here; see my hands. Reach out your hand and put it into my side. Stop doubting and believe” (John 20:29 ). Why didn't Jesus come down hard on Thomas's lack of faith? After all, He really blasted the Pharisees. I believe Jesus was gentle with Thomas because His tender heart sensed that the doubt of Thomas was born out of sorrow and painful questions about the reality of God's love. Jesus sensed that His formerly totally committed disciple (see John 11:16 ) was struggling. He wanted to believe but he couldn't. Because Jesus knew this, He was gentle, compassionate, and understanding. He didn't write Thomas off. The key to Jesus' tenderness and understanding is that He knew the heart of Thomas; He knew Thomas personally. That's the lesson for the healthcare Chaplain. Jesus ministered on a personal, intimate level and so should we, even if that means not presenting the Gospel, or not having prayer, or not trying to dig into a person's psychological baggage. Seeking to minister on the basis of a personal or professional agenda is not following the example of Jesus because it would put the needs and desires of the Chaplain first. In SummaryNo doubt it is your goal to minister according to the example of Jesus. The first step toward that goal is awareness . You must be aware of your deficiencies; of your tendencies to minister according to personal and professional agendas. Though sometimes painful, the discipline of self-evaluation is an absolute necessity for an effective Chaplain ministry. It is to be hoped that this paper will assist you in this process. Prayerful dependence upon the Holy Spirit is another absolute as you seek to minister according to the example of Jesus. Can a mere human hope to copy Jesus' compassion, insight, and ability to create the desire for the gift of God's grace? No, of course not. You are not, however, a mere human Chaplain. You have the Holy Spirit, who works through you to produce a supernatural ministry. More than hard work, more than many hours at the hospital, more than much training, you must saturate your ministry with prayer. Finally you must seek to be obedient to the example of ministry given by Jesus . From Jesus' encounter with the wayward woman, the blind beggar, and the doubting disciple, the following principles can and should be applied to your ministry as a Chaplain: • Ministry must be based on a personal knowledge of a patient or resident. It takes time and careful listening to understand and appreciate a person's concerns. • Chaplains must not bypass issues that are of concern to the patient/resident in order to get to spiritual issues. • Chaplains must seek to establish a relationship with the patient/resident, a process which often can be accomplished in just a few minutes. This relationship is built on the Chaplain's desire to hear a person's story, to reverence that story, and to communicate an attitude of presence with the person. It is a relationship built upon the trust a person has in the Chaplain when he senses that the Chaplain is not carrying out a role based on a faulty agenda. • Chaplains should seek to create in a patient/resident a desire for the gift of God's grace. This is best accomplished by being compassionate, sensitive, understanding, and patient. We should not try to push God's grace upon people. • The ministry of a Chaplain should be one of gentleness and tenderness. The chaplaincy and aggressiveness usually do not mix. • The Chaplain must remember that each visit and each patient/resident is unique. If the Chaplain functions essentially the same in each room, there is no doubt a faulty agenda at work, adversely affecting the ministry. I wish it were easy to minister in a healthcare facility each and every day without being influenced by personal and professional agendas. It saddens me as I think of the times I have allowed a faulty agenda to control my visit with a patient. It saddens me even more to acknowledge that I was aware of functioning according to an agenda even as I did it. Clearly, awareness is not enough. But praise be to God that He has given me His Spirit. He continues to work in my life and ministry, impressing upon me the need of avoiding the influences of personal and professional agendas through total dependence upon the Holy Spirit. This same Spirit also continues to impress upon me the need of obedience to the example of Jesus, and He gives me the power necessary to be obedient. I cannot think of a more exciting and challenging ministry than the healthcare chaplaincy. What a joy it is to know that the ministry He has given us, when carried out through the power of God, is going to be an effective ministry, in spite of our deficiencies, and that it will bring glory to the precious name of God. ¹Lawrence E. Holst , Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing, 1985), 46. ²Ibid., 46-52.
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